On modelling early life weight trajectories

Artículo de publicación ISIThere is broad recognition that early life growth trajectories can contribute to the study of the onset and development of several health outcomes.We review the random-effects specifications of two models that have been purposely developed to describe anthropometric data and a shape invariant random-effects model recently proposed in the statistical literature. They are compared in terms of their ability to extract salient and biologically meaningful features of growth in infancy and also to represent the data validly.We discuss advantages and limitations in choosing and interpreting each of the models by using longitudinal weight data taken from 0 to 4 years from three contemporary birth cohorts.TheNINFEAcohortwas partially funded by the Compagnia San-Paolo Foundation, Piedmont Region and Italian Ministry of University and Research. The Gerac˜ao XXI cohort was funded by Programa Operacional de Sade—Sa´ude XXI, Quadro Comunit´ario de Apoio III and by Administrac¸ ˜ao Regional de Sa´ude Norte. The GOCS cohort was funded by Fondecyt projects 1060785, 1090252 and 1120326

Photographic methods for measuring packaged food and beverage products in supermarkets

Background: The global obesity pandemic and rates of nutrition-related noncommunicable diseases (NCDs) have increased worldwide, especially in the Latin American and Caribbean region. In an attempt to control this obesity epidemic, the Chilean government has established a comprehensive set of regulatory actions, including beverage taxation, warning labels on foods, and marketing restrictions to children. To improve the effectiveness of actions to prevent obesity, a better understanding of the food environment is needed. Objective: We developed and standardized photographic methods to assess and monitor packaged food and beverage products in supermarkets. Methods: A standardized protocol and food categorization system was used to guide photo collection and data management of photos taken between February and April 2015 in 11 supermarkets, consisting of 5 different supermarket chains, from high-(n = 6) and lower-middle (n = 5)-income neighborhoods in Santiago, Chile. Photos (n =similar to 50,000) from nearly 10,000 unique food products from high-and lower-middle-income neighborhoods were used for this study. Results: We developed standardized methods to use photographs to assess and monitor the food environment. A food categorization scheme is essential to guiding the data collection process. Substantial time and human resources are required to assess packaged food and beverage products in supermarkets. Because the number of photos per food product is variable, the organization of the photographs according to the food categorization system, before data entry, is imperative for easy access during data entry and analysis. We identified the information necessary for a photographic registry, which, with the food categorization system, is critical to create unique identifiers that are linked to each food product and its photos. Conclusions: To adequately monitor food environments, standardized methods for food photo collection and management are essential. The information collected on food package photos to monitor food environments is important for guiding and evaluating actions in the context of the ongoing obesity and NCD epidemics.National Commission for Scientific and Technological Research (CONICYT)-National Fund for Scientific and Technological Development (FONDECYT) 3150183 International Development Research Centre 107731-00

Reply to AT Wijayabahu

This work was supported by Public Health Service grant R01 CA158313 from the National Cancer Institute, NIH, US Department of Health and Human Services (to KBM), and by the World Cancer Research Fund (2010/245)

Dynamics of the double burden of malnutrition and the changing nutrition reality

The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.United States Department of Health & Human Services National Institutes of Health (NIH) - USA: R01DK108148, P2C HD050924. World Health Organization. Gates Foundation

Demographic, social and health-related variables that predict normal-weight preschool children having overweight or obesity when entering primary education in Chile

We determined which variables are predictive of normal-weight (N) Chilean 4-year-olds developing overweight/obesity when entering primary school. This study used national data of preschoolers (PK, age 4) in 2011 through 2015, and the same children in the first grade (1st G, age 6) in 2013 through 2017. We formed longitudinal cohorts considering PK as the baseline and 1st G as the follow-up and included anthropometric, socio-demographic, and health variables in PK and anthropometry in the 1st G. We report the percentage N who remained N at follow-up (N-N) or gained excessive weight (N-OW) and (N-OB), by sex. We ran univariate logistic regressions to determine for each variable, its association with gaining excessive weight (N-OW + OB), incorporating significant variables (p < 0.001) in multivariate logistic regression. A total of 483,509 (251,150 girls) of PK had anthropometry in the 1st G. In PK, 22% of the children were obese; in the 1st G (24.8% and 19.7% in boys and girls, respectively). Of normal-weight children, 30% developed OW + OB. The predictive variables were: Being born macrosomic, attending a very vulnerable school, being indigenous, the mother’s low schooling, and the child being cared for by the grandmother after school. In this study, the factors predicting that normal-weight preschoolers gain excessive weight gain in a short period of time are mostly related to poverty. Prevention should focus on this population

Anticipatory effects of the implementation of the Chilean Law of Food Labeling and Advertising on food and beverage product reformulation

© 2019 World Obesity FederationThis study evaluated the anticipated food and beverage product reformulation by industry before the Chilean Law of Food Labeling and Advertising (Law 20.606) was implemented in June 2016 requiring a front-of-package (FOP) warning label for products high in sodium, total sugars, saturated fats, and/or total energy. Fieldworkers photographed a purposive sample of packaged food and beverage products in February 2015 (n = 5421) and February 2016 (n = 5479) from six different supermarkets in Santiago, Chile. The same products collected in both years (n = 2086) from 17 food and beverage categories with added critical nutrients (nutrients of concern: sodium, total sugars, and saturated fats) were included in this longitudinal study. The average change in energy and critical nutrient content was estimated by category. The number of warning labels potentially avoided because of reformulation was determined. Between February 2015 and February 2016, no category exp

Assessing the public health impact of Developmental Origins of Health and Disease (DOHaD) nutrition interventions

© 2014 S. Karger AG, Basel. Investing in the maternal and early-infancy periods (the first 1,000 days, i.e. from -1 to +2 years) is presently acknowledged as a key priority to ensure good nutrition and prevent all forms of malnutrition. The concept is to invest during this period to maximize the human development potential, and the early-life agenda includes prevention of stunting and promotion of optimal brain development as well as ensuring the quality of life of those who survive. Thus, public health assessments of specific interventions need to go beyond the traditional indices of prevention of death and disease. We need to consider including a full range of outcomes such as disability-adjusted life years (DALY) and quality-adjusted life years (QALY) and not only the number of deaths. The long-term outcomes of maternal and infant interventions to prevent obesity and related noncommunicable diseases remain uncertain in terms of their biological impact even under ideal conditions (e

Early BMI Gain and Later Height Growth Predicts Higher DHEAS Concentrations in 7-Year-Old Chilean Children

Background: Accelerated weight and height gain in infancy have been associated with premature adrenarche. However, the exact tempo of these events remains undefined. Thus, our goal was to assess the relationship between early BMI and height growth in different periods before 7 years of age and plasma DHEAS levels at 7 years of age. Methods: This is a longitudinal follow-up of participants of the Growth and Obesity Chilean Cohort Study (GOCS) that represents Chilean children from low- to middle-income families. The subjects were 972 children (48% girls) with birth weights of 2,500–4,500 g for whom serial weight and height measurements from birth until 7 years were available. At 7 years of age, we also measured DHEAS, IGF-I, leptin, insulin, and other metabolic markers in serum. The main outcome of interest was plasma DHEAS concentrations at 7 years of age. Results: At 7 years of age, children with DHEAS >75th percentile of the sample were taller and fatter and presented higher HOMA-IR and IGF-I than their counterparts ( p < 0.05). Children with higher DHEAS were heavier at 4 years of age and beyond compared to their counterparts (higher BMI [BMI SDS at 4 years: 1.16, 95% CI 1.02–1.29 vs. 0.83, 95% CI 0.76– 0.91, p < 0.001]) and taller at 7 years of age (height SDS at 7 years: 0.19, 95% CI –0.08 to 0.31 vs. –0.001, 95% CI –0.06 to 0.06, p < 0.005). Conclusions : We observed weight and BMI from 2 to 4 years, and height gains from 4 to 7 years were associated with higher DHEAS levels at 7 years

The Presence and Duration of Overweight Are Associated with Low-Grade Inflammation in Prepubertal Chilean Children

Background: Overweight is associated with low-grade inflammation, but it is under debate whether the effect of fat mass accumulation is acute or chronic. We aimed to study the association of overweight duration with low-grade inflammation in children in whom overweight initiation can be established. Methods: Observational longitudinal study, including a subsample of 250 Chilean children from the Growth and Obesity Cohort Study followed-up yearly since preschool age (n = 1195). At 4 years, 324 children provided blood. From those, 272 participants were evaluated at 7 years. The current analysis includes 250 children with a blood sample at 4 and 7 years of age and C-reactive protein (CRP) = 1) participants at 7 years, the duration of overweight (time since diagnosis) was computed and categorized according to tertiles: = 72 months. The independent association between overweight (diagnosis and duration) and low-grade inflammation (CRP >= 1mg/L) was studied (logistic regression models). Results: Overweight was associated with CRP >= 1 mg/L at 7 years [odds ratio (OR) = 2.93 confidence interval (95% CI = 1.60-5.38)], but not at 4 years [OR = 1.26 (95% CI = 0.71-2.26)]. An overweight duration = 1 mg/L [OR = 3.53 (95% CI = 1.21-10.28)] (reference = normal weight), whereas longer overweight durations (36-= 72 m) were not associated with CRP >= 1 mg/L [OR = 1.35 (95% CI = 0.41-4.40) and OR= 1.21 (95% CI = 0.35-4.18), respectively]. Conclusions: Overweight at 7 years of age was associated with low-grade inflammation only in the case of recent onset. Inflammatory disturbances may be associated with the early phases of excess weight.FONDECYT 11121391 112032